Prostate Cancer Treatments: Arch Enemy #1 to a Man’s Sex Life

By: Dr. Merrill Matschke Prostate cancer is the 2nd most common cancer in men after skin cancer. Interestingly, most men won’t have their lives shortened because of prostate cancer, BUT they may live the rest of their life suffering from the effects of the treatment. For some, they honestly feel the “cure is worse than the disease.” When treatment is indicated, concerns about sexual function are often put on the back-burner due to the stress and anxiety that comes with a diagnosis of cancer. In the months and years following treatment, men ultimately return to a more usual state of life, and interest in intimacy and an active sex life return to the front burner for many.

The reality remains, unfortunately, that damage has already begun in the tissues responsible for healthy sexual function. Many studies have shown loss of penile size — both length and girth — after treatment for prostate cancer. This begins almost immediately after the treatment and continues over time. The data shows this is most prominent in the men who have the most significant loss of erectile function after surgery. There are a few explanations for this, but most important is the loss of good blood flow to the erectile tissues within the penis. This happens immediately after the delicate nerves controlling erections are traumatized during the surgery to remove the cancerous prostate. Even if the nerves are “spared,” they are temporarily traumatized in the weeks to months after the surgery and erections are much less likely to occur. Ask any man that has had a “nerve-sparing” operation and he will confirm this. Thus, loss of penile size even occurs in men with nerve-sparing surgery.

The science has proven when the erectile tissue “sees” less blood flow, it begins to change. It literally begins to turn into scar. The feeling is that once the scarring process has set in, it is not reversible. Some reports have indicated a window of time during which this newly-formed scar may be able to be “resurrected” somewhat back to healthy tissue — but this is preliminary data. As we have learned how this process unfolds, strategies to “rehabilitate” the penis have been developed. These penile rehab programs have usually included use of one of the common ED medications on a regular basis in addition to a vacuum pump, and sometimes even penile injections with a medication called TriMix or prostaglandin. These approaches have been shown to help some men and is the current “standard of care” for men interested in minimizing the negative impact of prostate cancer treatment on erections.

Sadly though, the truth is, almost no man will return to the erection he remembered before his treatment. This is where urologists fail to be fully truthful. Most men are told they will have usable erections 50-70 % of the time after surgery using a pill. That’s not the full story. That 50-70% range relates to having an erection firm enough to penetrate. It does not mean 50-70% of the time you will return to your previous confident erection. Also, most men don’t realize these numbers are based on a time period of about 2 years after healing. Erections are virtually absent for the first weeks to months after surgery, and then begin to improve over time to max out at the 50-70% “usable” erection at about 2 years after surgery. During this entire time, the erectile tissue is suffering from reduced blood flow and changing to scar. The more rehab that is done, the less scar will be formed. Sadly, rehab is not always vigorously encouraged, and men are not always the type to be compliant with recommendations.

By combining the solid understanding of the changes in the tissues that happen after prostate treatment with new advances in the science of tissue regeneration and healing, we can now offer a much more effective approach to preserving the health of the erectile tissue BEFORE it begins to change. This concept truly is the holy grail to maintaining intact function. Proven therapies to optimize tissue healing, vascular health and grow new blood vessels already exist. These are being utilized successfully to treat a myriad of conditions throughout the body. At Better Life Carolinas, we feel these therapies perfectly coincide with — and promote — our mission to prevent disease BEFORE it happens. We have already been using these cutting-edge, office-based treatments successfully in men with ED. Our real excitement comes from the opportunity to potentially prevent the devastating effects of prostate cancer treatment that have grown to be expected, and, worse yet, accepted. We believe our approach can change this current reality and create a new paradigm where NO dysfunction is the only acceptable expectation.

Through prevention of permanent changes in the erectile tissue, we can maintain the normal healthy blood flow in the penis, thereby maintaining intact erections. These same regenerative therapies can also help improve any prior changes in the tissue that already existed from normal aging, high blood pressure, diabetes, smoking—basically any of the known vascular-related causes of erectile dysfunction. As Preventative Medicine specialists, we believe in going beyond the “standard” approach of the traditional sick model of medicine. We don’t want to wait for dysfunction. We choose to promote function to an optimal level by bringing together the latest science with all available therapies. At Better Life Carolinas, we believe in optimizing all facets to promote healthy living. When it comes to life after prostate cancer treatment, we have the strategies to take out the “enemy” before it can cause life-altering damage.

Let Better Life Carolinas help you get on with a full life after your cancer treatment. Call 843-737-2597 to schedule your appointment.